• ImmigrantSettlement

WorkersandSelf-Care:

ANecessity.........................1

• FromtheEditor................2

• Culture-SpecificMental

HealthServicesfor

Immigrantsand

Refugees............................5

• MentalHealthand

Migration:Journeyto

PromoteMentalHealth....7

• PostpartumDepression

amongImmigrant

Women.............................10

• InterpretersinMental

Health:APartofthe

Team.................................13

• VoicesofRefugees

Multimedia

Installation......................16

• “Welcoming

Communities”Priority

Seminar:HowCould

CanadianCommunities

BeMoreWelcoming?......18

• RacismontheInternet..21

• Multiculturalism–

Anti-RacismandAnti-

DiscriminationActivities:

WhatWorksandWhat

Doesn’t?...........................22

• ResCanNetBulletin........25

-RestoringFamily

Links................................25

Inside this Issue

Volume 23, Number 4, Spring 2010

I mmigration to Canada continues to be of prime importance. In the Annual Report to Parliament on Immigration, 2008, Jason

Kenney, Minister of Citizenship, Immigration and Multiculturalism, stated: “Immigration strengthens and invigorates our society, enriches our culture, supports Canada’s international commitment to protect refugees and contributes to the growth of our economy.” In the report, the federal government establishes the number of immigrants, refugees, and other categories of individuals who will be allowed to settle in Canada. It is anticipated that future quotas for new permanent residents will continue to range from 240,000 to 265,000 (Citizenship and Im-migration Canada 2009).

It is common knowledge that the majority of new-comers wind up residing in large urban centres and that service providers attempt to facilitate their settlement and adaptation in Canada. The official statistics provided by the federal govern-ment, however, may not capture what transpires from a practice perspective – the process of sec-ondary migration whereby immigrants initially settle in one part of the country but make the decision to relocate to another part of the country for reasons such as perceived better economic opportunities or the existence of a large number of individuals from the same country of origin. For example, during the decade 2000-2009 when Calgary experienced a prolonged period of eco-nomic growth, this city witnessed an influx of secondary migrants and became the fourth most popular city in Canada for immigrants/refugees to choose as their first place of residence.

These settlement trends, coupled with an environ-ment where resources for non-profit organizations are more difficult to obtain, are resulting in an

increased demand for services from frontline settlement workers employed in the immigrant-serving agencies and who represent the backbone of these agencies. This brief article explores the potential impact of these service demands on settlement workers who may be vulnerable to physical, emotional, and psychological stress that may affect their ability to work at an optimal level. Hence, it is extremely important for these “street-level bureaucrats” to tend to their personal health and well-being so they are able to work effectively with the clients who require the services provided by the immigrant-serving agencies.

The Context

As noted earlier, immigrant-serving agencies are viewed as key actors involved in the settlement pro-cess of immigrants and refugees. The primary roles of these organizations are: (1) addressing the needs of newcomer groups, (2) serving as links/bridges to mainstream organizations, and (3) advocating on behalf of immigrant and refugee communities. In order to provide the basic settlement services, immigrant-serving agencies also may provide a number of other programs to facilitate the adjust-ment of newcomers to Canadian society (Beyene et al. 1996).

The individuals primarily responsible for providing services to recently arrived immigrants/refugees and their families are the settlement workers, whose job functions include: (1) conducting client intakes, assessing their needs, and providing infor-mation; (2) making arrangements for interpretation and translation services; (3) linking service users to resources in the community that contribute to the

Immigrant Settlement Workers and Self-Care: A Necessity

Dr.DavidEste*

Immigrant Settlement Workers, continued on page 3

International Settlement Canada

* Professor, Faculty of Social Work, University of Calgary, <deste@ucalgary.ca>.

2 INSCAN Vol 23 ( 4 ) 2010

INSCANInternational Settlement Canada

Published quarterly byCentre for International Migration and Settlement Studies

(formerly Research Resource Division for Refugees)

From the Editor

I am pleased to announce that the Research Re-source Division for Refugees was re-launched as the Centre for International Migration and

Settlement Studies (CIMSS) on February 1, 2010. To mark the occasion, we held a panel discussion on international migration and settlement chal-lenges in the 21st century, which was attended by more than 80 guests representing research, policy, and service communities. The video of the panel discussion is available on Integration-Net at: <http://integration-net.ca/english/media/index.cfm>. Following the panel discussion, Dr. Roseann O’Reilly Runte, President and Vice-Chancellor of Carleton University, hosted a reception where Mr. Jason Kenney, Minister of Citizenship, Immigra-tion and Multiculturalism, gave a speech conveying his expectations from the research community.

The new centre will build on the 25 years’ work of its predecessor, which was established in the aftermath of the Southeast Asian refugee crisis of the early 1980s. This rebranding was a necessary move to do full justice to the scope of our current and planned activities. CIMSS will be an interdis-ciplinary hub for research, training, and publishing on international migration and settlement. Drs. Behnam Behnia and Adnan Türegün will serve as Academic and Executive Directors, respectively, of the centre.

We organized this issue around the theme of mental health and well-being among newcomers and those who work with them. Contributions to the theme came from:

• David Este, Faculty of Social Work, University of Calgary

• Soma Ganesan, Cross Cultural Psychiatry Program, University of British Columbia

• Raymond C.Y. Chung and Maria Lo, Hong Fook Mental Health Association, Toronto

• Paola Ardiles, BC Mental Health and Addic-tion Services; Cindy-Lee Dennis, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; and Lori E. Ross, Centre for Ad-diction and Mental Health, Toronto

• Angela Sasso, Provincial Health Services Authority in British Columbia.

Room 2106 DT, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6

Telephone: 613-520-2717; Fax: 613-520-3676E-mail: inscan@carleton.ca

Web site: http://www.carleton.ca/cimss/INSCAN.html

Editor: Adnan Türegün

Editorial Assistant: Katrina Eldridge

Administrator: Jana Eidem

Translation: Sinclair Robinson, Nandini Sarma

Layout and Printing: Carleton University Graphic Services

Editorial Advisory Board:

Kevin J. Arsenault, Harald Bauder, Chedly Belkhodja, Tara Blanchard, Sarah

Bukhari, Sherman S. M. Chan, Victoria M. Esses, Joseph Garcea, Jean McRae

The publication of this issue is made possible through financial assistance

provided by Citizenship and Immigration Canada.

Additional copies are available for $7.50 (+.38 GST).

Back issues of INSCAN are available for $5.50 (+.28 GST, single issues).

Subscriptions are $25.00 (+$1.25 GST).

Please enclose payment with orders and make cheques payable to: Carleton

University (CIMSS).

The views expressed in this publication are solely those of the contributors and do

not necessarily reflect the opinions of the Centre for International Migration and

Settlement Studies.

G.S.T. #118838937 ISSN #0845-2466

Minister Kenney and President Runte at the launch of CIMSS

3INSCAN Vol 23 ( 4 ) 2010

settlement process; (4) serving as advocates with different organizations; (5) offering orientation and counselling sessions on topics such as housing, education system, transportation, employment, and child care; and (5) providing outreach to assess community needs and promote programs. In ad-dition to these direct practice activities, settlement workers are expected to maintain records and sta-tistics for agency reports and to participate in staff meetings. Hence, the demands on these employees are constant.

Health and Well Being

With limited resources and greater demand for their services, settlement workers may be vulner-able to stress. According to researchers, stress is defined as a physical, mental, or emotional re-sponse to events that cause bodily or mental tension (Lazarus and Folkman 1984). More specifically, Palmer (1989) states: “Stress is the psychological, physiological and behavioural response by an individual when they perceive a lack of equilib-rium between the demands placed upon them and their ability to meet those demands, which, over a period of time, leads to ill-health” (p. 16). “Workplace stress” is the harmful physical and emotional responses that can happen when there is a conflict between job demands on the employee and the amount of control an employee has over meeting these demands (Canadian Centre for Oc-cupational Health and Safety [CCOHS] 2008). The four phases of workplace stress, their symptoms, and the interventions required for each are also detailed by the CCOHS: (1) warning, (2) mild symptoms, (3) entrenched cumulative stress, and (4) severe/debilitating cumulative stress reaction. There is general consensus within the literature that decreased job satisfaction, employee turnover, reduced effectiveness, absenteeism, illness, lack of motivation, and apathy are the result of the impact of this workplace stress. In addition, settlement workers may experience psychological and physical symptoms such as sleep disturbances, emotional and physical fatigue, depression, stomach ulcers, and eating disorders.

In conversations with individuals at the Fall 2009 Conference of the Alberta Association of Immigra-tion Serving Agencies, a number of them who work in agencies that provide settlement services shared the following comments: “We are very busy.” “We do not have enough staff.” “Several of our staff are ill.” I was left with the impression that these staff

members are overwhelmed. Collectively, these factors create a situation where settlement workers are overworked and lead one to ask the question: What can these employees and their employers do to protect their health under difficult work condi-tions? In many places of work, emphasis is placed on employee self-care, defined by the World Health Organization (1983) as activities individuals, families, and communities undertake with a view to enhancing health, preventing disease, limiting illness, and restoring health.

Human service employees such as settlement workers must ask why self-care is important. In the context of their work environment, attending to their health enables them to serve with maximum effectiveness. Based on my experience with and observation of settlement workers, these individu-als are extremely committed to helping immigrants and refugees adjust to Canadian society. It therefore is not unusual for them to disregard their personal wellness to assist newcomers. Working in this intense manner, however, may result in “burnout” defined by Leatz and Stolar (1993) as follows:

“Burnout is physical, emotional, and mental exhaustion caused by long-term involvement in situations that are emo-tionally demanding and very stressful, combined with high personal expectations for one’s performance.”

Settlement workers may experience burnout as a result of secondary traumatic stress, an outcome or risk related to engaging empathically with an-other’s traumatic experience.

The concept of self-care is multifaceted. Primary types of care include: (1) social, where emphasis is placed on having and using one’s support network; (2) physical, which stresses the value of an active lifestyle, proper sleep, and maintaining a healthy diet; and (3) mental / emotional, where proper time management, taking days off and vacation, and engaging in recreational activities are important. As suggested earlier, responsibility for ensuring employee self-care does not rest solely on the em-ployee. Employers are encouraged to pay attention to what is described as job design where activities such as the following are implemented to combat the workplace stress experienced by settlement workers: (1) ensuring that jobs are reasonably demanding by providing variety in job tasks, (2) providing opportunities for ongoing learning,

Settlement workers may experience burnout as a result of secondary traumatic stress, an outcome or risk related to engaging empathically with another’s traumatic experience.

Immigrant Settlement Workers, continued from page 1

This brief article explores the potential impact of these service demands on settlement workers who may be vulnerable to physical, emotional, and psychological stress that may affect their ability to work at an optimal level.

4 INSCAN Vol 23 ( 4 ) 2010

(3) entrusting employees with decision-making responsibilities, and (4) providing social support and recognition in the workplace.

Concept of Wellness

In recent years, the concept of “wellness” has re-ceived greater attention in the workplace. Corbin and Pargazi (2001) define wellness as a “multidi-mensional state of being describing the existence of positive health in an individual as exemplified by the quality of life and a sense of well being.” Various forms of self-care contribute to an indi-vidual’s wellness which is multifaceted in nature (social, spiritual, physical, emotional, intellectual). By paying attention to wellness in the workplace environment, human service organizations can attract and retain employees, reduce the impact of stressful workplaces, and improve staff morale, all of which contribute to the effectiveness and ef-ficiency of organizations. Both settlement workers and newcomers will benefit from the interventions implemented to enhance wellness in immigrant-serving agencies.

References

Canadian Centre for Occupational Health and Safety. 2008. Workplace Stress – General. Re-trieved December 10, 2009 from <http://www.ccohs.ca/oshanswers/psychosocial/stress.html>.

Citizenship and Immigration Canada. 2009. An-nual Report to Parliament on Immigration, 2008. Retrieved November 30, 2009 from <http://www.cic.gc.ca/english/resources/publications/annual-report2008/message.asp>.

Corbin, C. B., and Pargrazi, R. P. 2001. “Toward a Uniform Definition of Wellness: A Commentary.” President’s Council on Physical Fitness and Sports Research Digest 3 (15): 1-8.

Beyene, D., Butcher, C., Joe, B., and Richmond, T. 1996. “Immigrant Service Agencies: A Funda-mental Component of Anti-Racist Social Services.” Pp. 171-182 in Perspectives on Racism and the Human Services Sector: A Case for Change, ed. C. James. Toronto: University of Toronto Press.

Lazarus, R. S., and Folkman, S. 1984. Stress, Appraisal, and Coping. New York: Springer.

Leatz, C., and Stolar, M. 1993. Career Success / Personal Stress: How to Stay Healthy in a High-Stress Environment. Columbus, Ohio: McGraw Hill.

Palmer, S. 1989. “Occupational Stress.” The Health and Safety Practitioner 7 (8): 16-18.

World Health Organization. 1983. Health Educa-tion in Self-Care: Possibilities and Limitations. Geneva: Author.

Both settlement workers and newcomers will benefit from the interventions implemented to enhance wellness in immigrant-serving agencies.

ErratumIn our report on the Canadian Council for Refugees workshop titled “Migrant Workers” (INSCAN, vol. 23, no. 3 [Winter 2010], p. 24), the last two paragraphs should have read:

In his presentation, Roberto Jovel, Policy and Research Coordinator at the Ontario Council of Agencies Serving Immigrants, expressed the CCR’s point of view. The CCR has been campaign-ing for the rights of temporary workers for many years. It believes that the growth of temporary migrant work is in fact a bad practice for Canada. The recent changes to the TFW program allow employers to dictate who will be hired and the Canadian government to align immigration policy with economic policy. Far from enhancing workers’ rights, these changes penalize the workers by sending them back home after four years in Canada and barring them from applying again for six years. The CCR highlights that the program, originally designed to fill temporary labour shortages, has now expanded to a point where the number of temporary workers in Canada exceeds the number of permanent residents admitted in a year. This marks a dramatic policy shift for a country that has traditionally understood that immigrants should be admitted on a permanent basis. An elaboration of this position can be found on the CCR website at: <http://ccrweb.ca/temporaryworkers.htm>.

The workshop was concluded with closing remarks by Jovel in which he called for more govern-ment engagement with, scrutiny of, and controls on, employers – as opposed to expecting workers to bear the brunt of filing complaints – in order to ensure that temporary workers do not become victims of human trafficking.

5INSCAN Vol 23 ( 4 ) 2010

B efore entering into a discussion on culture-specific mental health services, let me begin by stating that we are all immigrants in

one form or another. Whether we were born in Canada and shifted locales from “the prairies” to “the rock” or travelled from the far corners of the earth to arrive in Canada – this process of moving to an unfamiliar or new environment defines im-migration. We need to recognize this as a starting point for our discussion of immigrant and refugee mental health.

Immigration and multiculturalism are the bedrock of Canada. In the most recent census, one in five Canadians was born outside of Canada (Statistics Canada 2007). With a declining birth rate, Cana-dians will need to rely increasingly on immigrants and refugees in order to prosper. It therefore be-comes our shared responsibility to ensure that they adapt and integrate successfully. We also need to ensure that Canada is a haven where newcomers feel physically, socially, and mentally safe. A key element in achieving this goal is appropriate and culturally responsible mental health services.

A chief concern of immigrants and refugees is men-tal health following migration (Ahmad et al. 2004). By definition, immigration is a stressful event that impacts lives on linguistic, cultural, social, and economic levels (Bhugra 2004a and 2004b; Meadows et al. 2001). As a result, immigrants and refugees experience stress and anxiety that impact negatively on their mental health (Mulvihill et al. 2001). Multiple studies have documented how im-migrants and refugees underutilize mental health services in Canada (Kirmayer et al. 2007; Sareen et al. 2005), and have identified barriers to service provision such as language, stigma, and treatment approaches to name but a few (Brown and James 2000; Chen and Kazanjian 2005; Fenta et al. 2006; Fung and Wong 2007; O’Mahony and Donnelly 2007; Whitley et al. 2006).

We must understand that utilization of mental health services in Canada by immigrants and refugees is not divorced from cultural factors.

Medical systems, of which mental health service delivery is a part of, are cultural systems which are socially defined responses to disease states. In contrast, illness is a nexus of individual experience, treatment, and social institutions. Consequently, beliefs about sickness, behaviours shown by sick persons (including treatment expectations), and the ways in which sick persons are cared for by their families and mental health service practitioners are cultural constructions shaped distinctly in different societies and social settings (O’Mahony and Donnelly 2007).

Taken together, this indicates that people’s expe-riences about mental health services are strongly connected to their own cultural background. In Canada, mental health care service delivery exists within a Western society and, therefore, primarily uses the Western medical model for diagnosis and treatment. When non-Western immigrants and refugees enter this system, they may face not only a different mental health care system from what they have experienced but also a different set of normative and cultural values.

From a systems perspective, there are several things that we can do as mental health adminis-trators and clinicians to improve the quality and delivery of services for immigrants and refugees. The first is ethno-culturally and linguistically responsible service delivery. As a whole, mental health policies and services do not generally reflect Canada’s diverse demographics and often do not offer an integrated approach appropriate to the needs and interests of immigrants and refugees. For example, English language competency is still a requirement in accessing and understanding infor-mation, mental health services, and participating in clinical trials (Ahmad et al. 2004). Ironically, this barrier was already discussed over 20 years ago (Canadian Task Force on Mental Health Issues Af-fecting Immigrants and Refugees 1988). Individual hospitals and facilities also vary in the quality of their language and interpretation services, ranging from untrained to professionally trained services (Canadian Task Force on Mental Health Issues

* Clinical Professor of Psychiatry and Director, Cross Cultural Psychiatry Program, University of British Columbia (UBC); Medical Director, Department of Psychiatry, Vancouver General Hospital and UBC Hospital; Medical Director, Adult Mental Health Services, Vancouver Community Mental Health Services; Physician Leader, Riverview Hospital, <soma.ganesan@vch.ca>.

Culture-Specific Mental Health Services for Immigrants and Refugees

SomaGanesan,MD,FRCPC*

By definition, immigration is a stressful event that impacts lives on linguistic, cultural, social, and economic levels.

When non-Western immigrants and refugees enter this system, they may face not only a different mental health care system from what they have experienced but also a different set of normative and cultural values.

6 INSCAN Vol 23 ( 4 ) 2010

Affecting Immigrants and Refugees 1988). The underutilization of interpreters by mental health care providers working with clients with language barriers remains common due to the perception that the process will be too costly and logistically difficult. However, this perception is unfounded.

Although services offered in languages other than English are limited, there are several languages available directly from service providers at public mental health sectors, such as the cross-cultural clinic or community mental health teams in Metro Vancouver. The cross-cultural clinic at Vancouver General Hospital provides outpatient services, including psychiatric assessment and psycho-edu-cation in 13 languages and dialects. In community-based services, there is a cross-cultural mental health liaison program that provides services to members of five target communities: South Asians, Chinese, Latin Americans, Vietnamese, and First Nations. Beside the liaison program, each mental health team provides services individually or in group settings in specific languages.

Another consideration is policy. Policy should reflect appropriate hiring practices with respect to ethno-culturally and linguistically specific service delivery. To that end, recruitment should focus on targeting ethno-cultural groups that reflect current immigration with a target of 10 to 20 percent being recruited from these groups. Furthermore, a strong leadership component needs to be integrated into clinical and administrative training. By doing so, a robust base is created that will facilitate future mental health services program development, as-sessment, decision-making, and identification of change agents.

Finally, cultural sensitivity – acceptance and re-spect for difference – is commendable, but may not affect clinical practice. My experience has been that very little change in clinical practice occurs in care providers as a result of cultural sensitivity training. As discussed previously, mental health care providers and immigrants and refugees are two fundamental parts of the mental health care system. These two parts are filled with cultural meaning and interconnected through social rela-tions (Kleinman 1980). Therefore, although the rationale for the practice of cultural sensitivity makes it possible to build rapport, it is not always guaranteed.

When immigrants and refugees reside in a differ-ent cultural setting, there is the potential that these two elements may become easily broken. That is,

communication patterns, cultural traditions, treat-ment recommendations, and the like which should be recognized and utilized may be discounted or go unnoticed (Brown and James 2000). What is required of administrators and care providers is a shift in paradigm from cultural sensitivity to cultur-ally responsible care. Such a shift moves mental health treatment and services from the level of the individual client and care provider, and imbeds them at the system and policy level. This allows monitoring, evaluation, and revision by all relevant groups as required.

These are just a few considerations with respect to how we can improve mental health service delivery to immigrants and refugees. I hope these thoughts will open a dialogue for future discussions so that we can all achieve this goal.

References

Ahmad, F.; Shik, A.; Vanza, R.; Cheung. A.M.; George, U.; and Stewart, D.E. 2004. “Voices of South Asian Women: Immigration and Mental Health.” Women Health 40 (4):113-130.

Bhugra, D. 2004a. “Migration, Distress and Cultural Identity.” British Medical Bulletin 69 (1):129-141.

Bhugra, D. 2004b. “Migration and Mental Health.” Acta Psychiatrica Scandinavica 109 (4):243-258.

Brown, D.E.; and James, G.D. 2000. “Physiological Stress Responses in Filipino-American Immigrant Nurses: The Effects of Residence Time, Life-Style, and Job Strain.” Psychosomatic Medicine 62 (3): 394-400.

Canadian Task Force on Mental Health Issues Affecting Immigrants and Refugees. 1988. After the Door Has Been Opened: Mental Health Issues Affecting Immigrants and Refugees in Canada. Ottawa: Minister of Supply and Services Canada.

Chen, A.W.; and Kazanjian, A. 2005. “Rate of Mental Health Service Utilization by Chinese Im-migrants in British Columbia.” Canadian Journal of Public Health 96 (1): 49-51.

Fenta, H.; Hyman, I.; and Noh, S. 2006. “Mental Health Service Utilization by Ethiopian Im-migrants and Refugees in Toronto.” Journal of Nervous and Mental Disease 194 (12): 925-934.

Fung, K.; and Wong, Y.L. 2007. “Factors Influenc-ing Attitudes towards Seeking Professional Help among East and Southeast Asian Immigrant and

What is required of administrators and care providers is a shift in paradigm from cultural sensitivity to culturally responsible care.

7INSCAN Vol 23 ( 4 ) 2010

Refugee Women.” International Journal of Social Psychiatry 53 (3): 216-231.

Kirmayer, L.J.; Weinfeld, M.; Burgos, G.; du Fort, G.G.; Lasry, J.C.; Young, A. 2007. “Use of Health Care Services for Psychological Distress by Immigrants in an Urban Multicultural Milieu.” Canadian Journal of Psychiatry 52 (5): 295-304.

Kleinman, A. 1980. “Major Conceptual and Research Issues for Cultural (Anthropological) Psychiatry.” Culture, Medicine and Psychiatry 4 (1): 3-13.

Meadows. L.M; Thurston, W.E.; and Melton, C. 2001. “Immigrant Women’s Health.” Social Sci-ence and Medicine 52 (9):1451-1458.

Mulvihill, M.; Mailloux, L.; and Atkin. W. 2001. Advancing Policy and Research Responses to Im-migrant and Refugee Women’s Health in Canada. Winnipeg: Canadian Women’s Health Network.

O’Mahony, J.M.; and Donnelly, T.T. 2007. “The In-fluence of Culture on Immigrant Women’s Mental Health Care Experiences from the Perspectives of Health Care Providers.” Issues in Mental Health Nursing 28 (5): 453-471.

Sareen, J.; Cox, B.J.; Afifi, T.O.; Clara, I.; Yu, B.N. 2005. “Perceived Need for Mental Health Treatment in a Nationally Representative Canadian Sample.” Canadian Journal of Psychiatry 50 (10): 643-651.

Statistics Canada. 2007. Immigration in Canada: A Portrait of the Foreign-Born Population, 2006 Census. Ottawa: Minister of Industry.

Whitley, R.; Kirmayer, L.J.; and Groleau, D. 2006. “Understanding Immigrants’ Reluctance to Use Mental Health Services: A Qualitative Study from Montreal.” Canadian Journal of Psychiatry 51 (4): 205-209.

Mental Health and Migration: Journey to Promote Mental Health

RaymondC.Y.Chung*andMariaLo**

A Training Series Attempting to Connect Settlement and Mental Health Sectors with a Focus on Wellness and Reducing Stigma

Settlement is a health issue. Even though “mental health” is being increasingly recognized as an important aspect of the settlement process, a cul-turally sensitive training program for settlement service workers working with diverse newcomer communities has yet to be developed. Recognizing this need, the Ontario Council of Agencies Serving Immigrants (OCASI) and the Hong Fook Mental Health Association (Hong Fook) began a dialogue in early 2007 to discuss the possibility of a part-nership to provide training sessions for settlement workers from across the province.

As numerous studies on the determinants of health of immigrants and refugees show, immigrants are healthier than the Canadian-born population when they first arrive in Canada but lose their health advantage over time. This is not surprising considering the fact that poverty, isolation, and

marginalization are determinants of mental health, which have the greatest impact on refugees, youth, women, and seniors. Recent research shows that, despite their declining health status, immigrants underutilize health services, particularly, in the areas of prevention of mental illnesses and promo-tion of mental health.

During the recent Consultations on the Settle-ment and Language Training Services Needs of Newcomers in Support of the Canada-Ontario Immigration Agreement,1 immigrant participants said that they experience loneliness and depression as a result of social isolation and with the immigra-tion experience itself. Immigrants and participants from settlement agencies both expressed the need for the education, awareness, and training of im-migrant service workers to enhance their capac-ity in working with newcomers who are dealing with mental health issues and to increase their knowledge of mental health services in making appropriate referrals.

* Trustee, Hong Fook Mental Health Association, Toronto, <rchung@hongfook.ca>.** Mental Health Worker, Hong Fook Mental Health Association, Toronto, <mlo@hongfook.ca>.1 <http://www.cic.gc.ca/ENGLISH/resources/publications/settlement/coia-summary.asp>.

As numerous studies on the determinants of health of immigrants and refugees show, immigrants are healthier than the Canadian-born population when they first arrive in Canada but lose their health advantage over time.

8 INSCAN Vol 23 ( 4 ) 2010

Raymond C.Y. Chung at a training session

There are many reasons why immigrants tend to shy away from mental health services. Among them are: 1) lacking awareness of the impact of the migration process on mental health; 2) lacking accurate knowledge of mental illnesses; 3) stigmatization associated with mental illness among the diverse cultures; 4) issues concerning the availability of and accessibility to the mental health care system; and 5) lack of affordability to specialized mental health services through avail-able health plans.

Barriers to accessing services concern: 1) cultures and languages; 2) cultural competency of service providers; 3) availability of support and rehabilita-tion services; 4) non-compliance with treatment; and 5) knowledge base of settlement service providers on available mental health services. In order to facilitate appropriate referrals, settlement service providers would need to enhance their knowledge base on mental health and to build capacities in identifying issues and symptoms relating to mental health among individuals ap-proaching them for service.

Moreover, the working conditions, health and mental health status of settlement service provid-

ers are areas of concern as well. A report prepared jointly by the Community Social Planning Council of Toronto and Family Services Toronto, On the Front Lines of Toronto’s Immigrant- and Refugee-Serving Sector (p. 14),2 indicates that “[m]ost staff reported working overtime hours on a regular basis. Thirty percent of participants were unpaid for their overtime hours. In addition, over one-quarter of participants did not receive dental or health ben-efits and almost half did not have a pension plan. These conditions, when exacerbated by excessive workloads, lack of opportunity for advancement, lack of appropriate professional development and the stressful nature of the work, undermine the sector’s capacity to attract and retain talented workers.” A strategy in dealing with “burnt-out” symptoms and the high staff turnover rate is very much needed in the sector. Thus, training the settlement workers with a focus on holistic health and emphasizing self-care could provide a much needed preventative measure.

It is with this goal in mind that in early 2008, OCASI in partnership with Hong Fook submit-ted a project proposal titled “Journey to Promote Mental Health” for funding to Citizenship and immigration Canada. The funding was received in

2 <http://socialplanningtoronto.org/wp-content/uploads/2009/01/on-the-front-lines_immigrant-sector_july-2006.pdf>.

In order to facilitate appropriate referrals, settlement service providers would need to enhance their knowledge base on mental health and to build capacities in identifying issues and symptoms relating to mental health among individuals approaching them for service.

9INSCAN Vol 23 ( 4 ) 2010

September 2008. The project seeks to provide in-teractive workshops for settlement service workers with the key objective of enhancing their capacity in addressing the mental health issues presented by the individuals they serve and making timely referrals to appropriate services in the mental health and community health systems.

Specific expected outcomes of the project include:

• Increased knowledge of mental health issues and migration

• Increased awareness of the significance of early identification of mental health issues and coping strategies

• Enhanced knowledge of the mental health sys-tem and community mental health resources

• Increased knowledge of a culturally competent approach

• Increased knowledge of compassionate com-munication

• Increased awareness of self-care by service providers

Philosophically, Hong Fook uses a social justice approach within a holistic health framework. Thus, the training is conducted with the perspective of mental health as a continuum and a service ap-proach that is in accordance with the underlying values and philosophies on empowerment and capacity building, diversity and cultural com-petence, wellness and recovery, and community participation.

The key areas covered in this training are as fol-lows:

1. Mental Health and Its Determinants within a Holistic Health Framework

2. Migration and Mental Health-Related Issues

3. Myths and Facts about Mental Health and Mental Illness

4. A Culturally Competent Approach and Ef-fective Communication: What Can Service Providers Do?

5. Mental Health System and Community Re-sources

6. Importance of Self-Care among Service Pro-viders

These training series feature small group discus-sions, case studies, role-play, and sharing of knowl-

edge that could be applied to everyday practices, and are beyond just theories. The training team has completed four training sessions as part of the series in this past year and three of these sessions were conducted outside Toronto. Initially, the train-ing team was planning to have maximum 20 to 25 participants for each of these sessions. However, the demand was so great that each session had an average of 34 people attending. As a result, we did not have enough time for in-depth discussions and sharing. Moreover, participants varied greatly in terms of the knowledge of these topics. It be-came quite difficult to accommodate the needs of everyone. The training team had to constantly adjust the approaches and the curriculum based on the feedback from the participants. The feedback helped us realize that case studies based on real life experiences are especially useful and much appreciated by all. The participants felt that they could learn most through these firsthand narrative exchanges as they could help them identify effec-tive ways to assist those in need.

Responses from the participants in these training sessions have been very positive and encouraging so far. The training has definitely had an impact on them as it is reflected in the pre- and post-training questionnaires on various mental health-related issues that they completed. The findings from these questionnaires have demonstrated that not only have they gained more information on these areas, there were also significant changes in their attitudes and approaches when working with cli-ents living with mental health issues.

The demand for and outcome of these four train-ing sessions show that there is a continuous need to provide basic training on this topic and, more importantly, for ongoing consultation with and support to settlement service workers. The train-ing reached approximately 130 participants in the past year but there are many times more settlement workers in Ontario. It is important to note that the series also drew interest from frontline staff from social services, those involved in early years education, LINC teachers, and school counsellors. Based on the positive responses and the outcomes, the training team is hoping that the project could be extended for at least one more year in order to reach out to more frontline settlement workers.

Settlement is essentially a health issue and mental health is an important aspect of the settlement process.

10 INSCAN Vol 23 ( 4 ) 2010

What Is Postpartum Depression?Although childbirth is a common experience for women, it can also represent for some a time of great vulnerability to psychological problems, varying in severity from the “baby blues” to post-partum psychosis, a serious state affecting less than one percent of mothers. Postpartum depression (PPD) is a major health issue for many women, including immigrant women.

The cause of PPD remains unclear but research to date suggests that risk factors for PPD are generally consistent across different ethno-cultural groups, such as experiencing depression before or during pregnancy. Lack of social support and low socio-economic status are also significant risk factors for PPD, and may be a particular concern for immi-grant women. For instance, a key factor associated with immigration and the post-migration context can be stresses associated with acculturation.

Recent research suggests immigrant status is in itself a risk factor for PPD. According to a recent Canadian study (Dennis et al. 2004), immigrant women were five times more likely to develop depressive symptoms in the early postpartum pe-riod in comparison to Canadian-born mothers. In adapting to their host country, immigrant women face many challenges, such as learning a new lan-guage, adapting to unfamiliar customs, adjusting to a different manner of social interaction, and accepting new rules and laws. Also, immigration is often associated with a significant change in the family’s socio-economic status (e.g., if education or work experience is not recognized in the host country) that may contribute to PPD.

Some immigrant women (especially recent im-migrants of colour) may face a “triple jeopardy” of simultaneously belonging to various marginal-ized groups. They can experience ethnic or racial

prejudice, sexism, and discrimination because of their immigrant status. Results from a recent study conducted in Toronto revealed that immigrant women in Canada often feel discriminated against as immigrants and as mothers (Ross et al 2007). Specifically, some participants noted that Canadian society was unfriendly towards mothers and small children, and reported that on occasion they have felt discriminated against in public when people judged that their baby was crying too loudly or that their stroller was in the way.

While acknowledging diversity within ethno-cultural groups, some research has also pointed to various culturally specific risk factors for PPD. For instance, research has pointed to a link between having a baby girl and postpartum depression among women in Hong Kong and India. Other culturally specific family variables that have been identified as possible risk factors include lack of practical support from the baby’s father and a poor relationship with in-laws. It could be argued that these variables are equally relevant to PPD in Western cultures, considering the strong link be-tween a lack of social or partner support and PPD.

One factor that may have a protective effect on the development of PPD in some women is traditional postpartum rituals. Traditional practices include organized support (e.g., female relatives caring for the new mother), dietary restrictions, hygiene practices, and restricted physical activities. For example, Tso-Yueh-Tzu or “doing the month” is a traditional ritual performed by many Chinese postpartum women. In most cultures, these prac-tices are typically performed for 30 to 40 days after delivery. Other researchers suggest that PPD may develop less frequently, or is easier to cope with, in religious women because of the more cohesive social structure, emphasis on rituals, and greater community support. However, other studies sug-gest that, for some women, childbirth traditions can be a source of stress for immigrant women,

* Manager, Education and Population Health, BC Mental Health and Addiction Services, Vancouver, <pardiles@bcmhs.bc.ca>. ** Associate Professor and Canada Research Chair in Perinatal Community Health, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, <cindylee.dennis@utoronto.ca>. *** Research Scientist, Social Equity and Health Research Section, Centre for Addiction and Mental Health, Toronto, <l.ross@utoronto.ca>.

PaolaArdiles,*Cindy-LeeDennis,**andLoriE.Ross***

Postpartum Depression among Immigrant Women

Recent research suggests immigrant status is in itself a risk factor for PPD.

11INSCAN Vol 23 ( 4 ) 2010

particularly, those who do not have enough support or resources to adhere to, or participate in, prac-tices believed to be important to health. If a woman cannot participate in her cultural traditions, she may attribute future symptoms of depression to her failure to do so. Additional research is warranted to better understand risk and protective factors for PPD in diverse ethno-cultural groups in order to create appropriate interventions and policies that are applicable for immigrant women.

Strategies for Working with Immigrant WomenThis section highlights strategies based on mental health promotion principles aimed at delivering postpartum care to immigrant women.

Delivering Culturally Appropriate Care

Participate actively in diversity and cultural com-petency training and in designing culturally ap-propriate care. Workplaces can integrate cultural competency policies and practices at various levels, including the planning and delivery of services. Culturally appropriate care suggests that awareness as well as incorporation of the concerns and issues faced by immigrant mothers – such as language barriers, lack of social support, change in socio-economic status, lack of access to certain care and services owing to their citizenship status and racism, and acculturative stress – are important. It is also salient that professionals working with new immigrant mothers be aware of other contextual factors that may have an impact on psychological adjustment to a new country, such as their experi-ence of trauma prior to migration.

Addressing Language Barriers

Use trained and certified cultural interpreters. Ideally, mothers should be assessed for postpartum depression without family members’ presence. If a mother is not proficient enough to understand, read, and speak in English, interpreters who are culturally competent should be incorporated in the assessment and care planning. It is also important to disseminate information about the Canadian health care system, particularly, as it relates to maternal and infant care (i.e., labour and delivery practices, vaccinations), postpartum depression, treatment choices, and support services. Such in-formation should be provided in multiple languages and through diverse channels such as brochures, educational videos, websites, and radio.

Creating Supportive Environments

Help a new immigrant mother to establish con-nections with other members of her community/communities. An important initial step in support-ing immigrant women is to help them navigate an unfamiliar health care system. Health professionals should familiarize themselves with community-based services for new mothers, fathers, and families. Referring women to other community and social services may also be pivotal in their obtaining resources that provide comprehensive and supportive care. Immigrant mothers often welcome the support of health professionals who share their language and culture. However, there can also be many negative aspects to these strate-gies. Not all immigrant communities will have ethno-culturally specific supports for new mothers and their families. Furthermore, relying solely on ethno-specific services may lead to further stig-matization and isolation.

Addressing Life Context and Determinants of Health

Take into account the context of the everyday lives of the mothers when implementing programs and policies. Many of the strategies for working with women experiencing general depression can also be effective when working with postpartum mothers. However, there are some specific issues that require attention. For instance, it is key that services for mothers include providing child care and transportation costs. In addition, pregnancy and childbirth may be a time when traditional gender roles are accentuated. Partners and family members may hold unrealistic expectations about motherhood and may exert additional pressure on a new mother by criticizing her appearance or untidiness or success in caring for the baby. Part-ners and family members thus need to talk, prior to the birth, about what is reasonable to expect from the mother. Information about PPD should also be provided to both women and their family members to clarify the seriousness of postpartum depression as well as to reduce the potential stigma associated with seeking treatment. Otherwise, the woman’s depressive symptoms might be dismissed as the “blues.”

Building Partnerships within the Organization and Beyond

Work in multidisciplinary teams within one’s own workplace and build partnerships with external agencies. Collaborative work is more effective in addressing the complex issues (e.g., employment,

An important initial step in supporting immigrant women is to help them navigate an unfamiliar health care system.

12 INSCAN Vol 23 ( 4 ) 2010

health care, legal issues, and housing) that affect the mental health of postpartum immigrant women. By working together towards common goals, dif-ferent organizations and stakeholders can build on unique competencies and perspectives. Service providers can work towards generating policies and making organizational change to create healthy environments that support postpartum mothers.

Using Multiple Approaches and Levels

Use a combination of methods (i.e., education, policy change, community development, collabo-ration) and work at multiple levels (i.e., individual, family, community, organizational, societal) to provide comprehensive care. Adopting multiple approaches will also allow service providers to be more responsive to new information or evidence. For example, if research reveals that involving partners in the treatment of PPD is an effective strategy, postpartum programs should aim to involve partners.

Conclusion

There are many commonalities in the experience of PPD, regardless of a woman’s immigrant status. However, many of the issues related to PPD and immigrant mothers are complex and it is impor-tant to recognize that each mother is unique. For instance, the support from the extended family may play a prominent role for many women cop-

ing with PPD. In other cases, religion may have a significant impact on a woman’s healing strategy. Incorporating a holistic approach to health by considering the different aspects of a mother’s physical, social, emotional, and spiritual health; as well as the context in which immigrant mothers live (discrimination, poverty, social isolation) is critical to understanding PPD in immigrant women.

References

Dennis, C.-L., Janssen, P.A., and Singer, J. 2004. “Identifying Women At-Risk for Postpartum De-pression in the Immediate Postpartum Period.” Acta Psychiatrica Scandinavica 110 (5): 338–346.

Ross, L.E., Ardiles, P., Mamisachvili, L., Mance-wicz, G., Rabin, K., and Stuckless, N. 2007. Un-derstanding the Role of Culture in Postpartum Mood Problems: A Pilot Project. Unpublished manuscript.

Editor’s Note: Adapted from Ardiles, P., Dennis, C.-L., and Ross, L.E. 2008. “Postpartum Depres-sion among Immigrant and Refugee Women.” In Working with Immigrant Women: Issues and Strategies for Mental Health Professionals, ed. Sepali Guruge and Enid Collins. Toronto: Centre for Addiction and Mental Health. The book can be ordered online at: <http:www.camh.net/Publica-tions/Resources_ for_Professionals/Working_Im-migrant_Women/>.

13INSCAN Vol 23 ( 4 ) 2010

* Manager, Communications and Consulting, Provincial Language Service, Provincial Health Services Authority in British Columbia, Vancouver, <asasso@phsa.ca>.

I n 2005, the Provincial Language Service (PLS), a program of the Provincial Health Services Authority in British Columbia (PHSA), adopted

a training program – Mental Health Interpreting: A Team Approach – specifically dedicated to instruct-ing interpreters and mental health care profession-als on how to better work together in mental health. Although excellent court and health care training programs were available through the Vancouver Community College Interpreting Programs, the specialized area of mental health was still largely overlooked. Moreover, interpreters trained in in-terpreting in health care were themselves asking for support, guidance, and assistance in navigating their way through the mental health appointment. Interpreting in mental health is a unique situation that requires specialized training. The Mental Health Interpreting: A Team Approach training program brings together the interpreter and the mental health team of professionals to support the non- or limited-English speaking client.

Immigrating to a new country can be one of the most difficult changes that an individual under-takes. Leaving behind family, friends, culture, and familiarity for a new life with many unknowns often leads to stress and anxiety. It may also act as a catalyst for the introduction of other conditions manifested physically, emotionally, and mentally. The way in which an individual comes to Canada is also important. Was it a personal choice to im-migrate or did external forces such as war or per-secution dictate the change? Is the individual alone or with family and friends? Are they responsible for others or are they dependent on others to care for them? Each of these situations can be difficult. Add to this experience the further complications of coping with a mental health issue and a lack of language skills and the situation intensifies. Newcomers who do not speak either of Canada’s official languages are often left seemingly power-less or voiceless to access the resources they may desperately need.

Mental health care is a dynamic situation – as much for the individual experiencing mental health concerns as for the family and friends around the

individual. It is also set in a sea of stigma and cul-tural constructs. How mental illnesses are defined, viewed, discussed, and treated in this country may be significantly different from the ways in which mental health is perceived in any of the multitude of countries represented by the many immigrants and refugees who seek a home in Canada. A men-tal health interview or appointment is a critically important step in understanding the individual, understanding the mental health concern at issue, and in the establishment of a trusting relationship between mental health care provider and client. When the mental health care professional and the client do not speak the same language, how can an assessment of the mental health concern at hand be conducted?

Immigration to Canada continues to increase. The 2006 Census shows that the proportion of the foreign-born to Canada’s total population was at its highest in 75 years and that, between 2001 and 2006, Canada’s foreign-born population grew by 13.6 percent – four times faster than the Canadian-born population (Statistics Canada). As our society becomes increasingly multilingual and multicultural, employing practices that facilitate communication across languages is critical, and the most promising practice is utilizing the skills of trained language interpreters.

“When I interpret at an appointment with the mental health team, I find that it is difficult to maintain my role as an interpreter. The client’s speech is difficult to understand and I cannot interpret as I’ve been taught. Also, the mental health care professional seems to think that it is my fault if the client is not answering the questions asked or if I am unable to capture all of the dialogue.” Freelance Interpreter

Working in the area of mental health can be a demanding and challenging task for an interpreter. The context of mental health does not easily lend itself to the smooth back and forth dialogue that many community-based interpreting sessions in-volve. The mental health setting can be dynamic

Interpreters in Mental Health: A Part of the Team AngelaSasso*

The Mental Health Interpreting: A Team Approach training program brings together the interpreter and the mental health team of professionals to support the non- or limited-English speaking client.

14 INSCAN Vol 23 ( 4 ) 2010

and, at times, unpredictable: The dialogue between health care provider and patient or client may be unfamiliar to the interpreter. The client’s speech may be disfluent or rapid in pace. Capturing mean-ing becomes difficult for the interpreter. The cli-ent’s behaviour may seem odd, and the therapist may appear to be asking questions that provoke the client. The situation can become emotionally chal-lenging for an interpreter if s/he is unfamiliar with the goal of the session or with types of behaviours one encounters in mental health.

The traditional role of the interpreter is one of language facilitator. Community interpreters uti-lize various professional skills and techniques to conduct their work: Interpreters interpret in con-secutive mode, interpreters do not interject, nor do they provide cultural or personal information about the client, and interpreters faithfully interpret the meaning of one speaker’s utterances into a package that is understood in the language of the listener. The interpreter is a language conduit. And, should the attending professional have a question about the client’s culture, the interpreter can relay that request to the client and have the client respond in his/her own words.

Interpreters are trained to let the speakers speak for themselves. Interpreters must faithfully, transpar-ently, and accurately transmit the message of the speaker, ensuring that the meaning is rendered in the other language. It is only with accurate com-munication that both the patient and the health care professional can reach a common understanding of the presenting issues, and course for treatment, should there be any.

In mental health, the conversational flow is not al-ways as prescribed or as even as in other situations. In addition to a potentially emotionally charged environment, interpreters may find themselves working with clients who are not coherent, who are resistant, or who may exhibit odd behaviours. Clients in a mental health appointment may also not feel comfortable having an interpreter present, thereby inhibiting an honest conversation with the mental health care professional.

It is with these realities in mind that the Mental Health Interpreting: A Team Approach training was designed. The model presents an innovative approach to interpreting in a mental health set-ting as it takes into consideration the unique and diverse cultural manifestations of mental health.

The model and training curriculum incorporate cultural awareness and allow the interpreter to ad-dress cultural issues with the mental health worker and client. The Mental Health Interpreting: A Team Approach supports the role of the interpreter as a contextual and cultural facilitator, and as an integral part of the team. This approach to inter-preting in mental health involves training not only the interpreter but also the mental health worker. The training provides mental health care work-ers with an opportunity to better understand the role of an interpreter within a mental health care encounter. Mental health care workers also learn tips and techniques on how to work effectively with interpreters within the mental health team approach model. Mental health workers explore the various cultural contexts of mental health and the ways in which an interpreter can support and facilitate the mental health professional’s relation-ship with the client.

The central position of the training is that the interpreter has a more fluid position in the mental health appointment: Rather than a conduit, the role of the interpreter is that of a pendulum. Utilizing a decision-tree process, the interpreter decides whether or not to take on additional roles within the session. Other core elements of this approach are:

· The interpreter is part of the mental health team – working in concert with the mental health professional. This is generally not the case for most community-based interpreting sessions. Interpreters may have some minor background information about the session they are about to work in but, for the most part, interpreters largely walk into a session with very little information. In the team ap-proach model, interpreters become a more integral part of the team, often meeting with the mental health team both before and after an appointment.

· The same interpreter is used for the client for all mental health appointments. In most situ-ations, interpreters are assigned to a session on an ad hoc basis, permitting that the skills required are present. In the team approach model, special attention is given to ensuring that the same interpreter is assigned to the same client. This builds a foundation of trust and consistency, which is so important in mental health.

15INSCAN Vol 23 ( 4 ) 2010

· The interpreter may intervene according to a set procedure. Intervention is an interjection that is introduced by an interpreter during a community-based interpreting session. Inter-preters are generally discouraged from inter-vening and must only do so if the intervention works to facilitate communication and assist the interpreter in his/her role. In the Team Approach model, interpreters are given more flexibility to intervene. Although still gov-erned by a set process, the model permits an interpreter to contribute his/her professional knowledge around culture and mental health if it facilitates the session. This is why the training is so critical in that it provides the interpreter with information on culture and the goals of the mental health session.

· Interpreters may move between consecutive (interpreting after the speaker has said 1 -3 sentences), simultaneous (interpreting just a few word behind the speaker), summary (paraphrasing what the speaker has said), and descriptive (describing how the speaker is speaking or s/he is saying) techniques, depending on the situation. Consecutive and simultaneous techniques are the accepted modes of interpreting. Summary or descrip-tive interpreting is not considered interpret-ing techniques. However, in a mental health appointment, where the client’s speech may become incoherent, disfluent, rapid, or gener-ally incomprehensible to the interpreter, what is important is that the mental health care professional is aware of what is being said, or how it is being said, even if the content is transmitted by summarizing or describing the speech.

“Mental health interpreting is quite different from regular health care ap-pointments in many ways. I have to pay attention very carefully to catch the cli-ents’ words, voice, moves, gestures, and even their attitude. And in mental health interpreting I try to interpret as literal as possible while maintaining clarity of expression and literary excellence.” Robin, Korean Interpreter (PLS)

It is critical that the interpreter and the mental health team work together so that, during the appointment, there are no surprises for anyone

involved. This means discussing beforehand which interpreting modes will be utilized, depending on the situation: e.g., consecutive versus simultaneous.

“The biggest challenge for me has been that psychotic or hallucinated patients refer to characters in Chinese fairy tales, which present difficulty for me to interpret and also difficulty for the health care professional to comprehend.” Mike, Mandarin Interpreter (PLS)

Since the interpreters taking the Mental Health In-terpreting: A Team Approach training are already trained as health care interpreters, the training focuses primarily on the mental health context and also places a large emphasis on culture. Along with the interpreter’s own cultural orientation towards mental health, different cultural views on mental health are explored. Culture is a core component of the training. In addition to the content delivered by instructors, the training also involves guest speakers who share their expertise around mental health and the mental health care system.

The Mental Health Interpreting: A Team Approach course is the only training of its kind in British Columbia and is unique in its understanding of the relationship between mental health care provider, client, and interpreter. Over the last five years, the PLS has trained over 100 interpreters across the province in mental health interpreting. In the past year alone, the PLS received 300 requests for mental health interpreters – mostly in Cantonese, Punjabi, Vietnamese, and Mandarin.

“It is no doubt that the training was help-ful in two folds. First of all, interpret-ers are more familiar with the terms used in the field. Secondly, interpret-ers are taught how to deal with some common situations in mental health.” Mike, Mandarin Interpreter (PLS)

The Mental Health Interpreting: A Team Approach program was developed by Angela Sasso and Kiran Malli, both of the PLS. As a program of the PHSA, the PLS provides comprehensive language services, including interpreting, translation, consulting, and training. Interpreting services include both in-person and immediate telephone interpreting in over 150 languages. For more information please visit: <http://www.phsa.ca/pls>

It is critical that the interpreter and the mental health team work together so that, during the appointment, there are no surprises for anyone involved.

16 INSCAN Vol 23 ( 4 ) 2010

* Media Artist, Ottawa, <voices.of.refugees@gmail.com>.

T he Voices of Refugees Multimedia Instal-lation is a collaborative portraiture, video, and live performance project that engages

artists and activists from the refugee community. It provides an opportunity for refugees to tell their stories and celebrate their achievements through the creation of a modern multimedia installation. For example, the following is an excerpt from one of the Voices of Refugees’ videos:

“I was almost killed in my country, I was tortured. … I have found some peace in my heart, after two horrible experiences in prison. … More than one week the first time, with no food, no sleeping, no water. Being beaten up by seven soldiers. … The first time I was put into a torture chamber, they put me on a chair, and I was blind folded, I was handcuffed in the back. There was a minute of silence, complete silence, before they started to beat me up. It was at that point when I could feel them around me – the breathing of these ... people.” (Victor Fuentes, a musician/painter from El Salvador)

When Is the Next Presentation of the Voices of Refugees Multimedia Installation?

The Voices of Refugees Multimedia Installation is planning a five-day event from June 16 to 20 at Library and Archives Canada during World Refugee Week 2010.

Who Are Our Supporters?

We have been very fortunate to receive support from the City of Ottawa, the Canada Council for

the Arts, Ontario Arts Council, the United Nations High Commissioner for Refugees, Library and Archives Canada, the Centre for Afghan Progress, the University of Ottawa, the University of Oxford (England), Carleton University, York University, Ottawa Community Immigrant Services Organiza-tion, the World University Service of Canada, the Canadian Centre for International Justice, and the Coalition of New Canadians for Arts and Culture.

Who Is Organizing the Project?

The Voices of Refugees project has been developed by Sherry Tompalski (installation designer) and Graham Thompson (videographer). The concept was based on the realization that many refugee artists and activists arrive in Canada with highly developed artistic skills and compelling personal stories of survival. As a result, the refugees’ work is uniquely suited to a multimedia presentation where audiences have the opportunity to see, to hear, and to understand their personal accounts of, for example, walking across Chad, without food or money to escape the horrors of Darfur.

What Is the Method and Process of the Project?

Tompalski and Thompson endeavour to create an environment for audiences to interact with the refugee artists and activists. Thompson engages the refugees in the creation of a short video about their work. Tompalski creates large-scale portraits of the refugees. In combination, they create a backdrop for the presentation of refugees’ work – setting the stage with multiple video screens and pictures of the refugees. As well, Thompson and Tompalski employ the use of posters, vinyl banners, websites, and streaming media to publicize the project.

What Are the Benefits of Voices of Refugees Project?

The Voices of Refugees project helps to:

· Promote inter cultural dialogue.

· Provide a forum for the personal expression of refugees.

· Address problems of isolation and cultural barriers that refugees may face.

· Acknowledge the courage, determination, and energy refugee populations have brought to Canada.

GrahamThompson* Voices of Refugees Multimedia Installation

17INSCAN Vol 23 ( 4 ) 2010

What Is the History of the Voices of Refugees Project?

Parliament of Canada – June 16, 2009As part of World Refugee Week celebrations, the Voices of Refugees Multimedia Installation featured eight portraits of refugees from Central America, Central Asia, and Africa; segments of their life stories were displayed on four large screen video monitors; and a live performance with Guatemalan revolutionary singer Tito Medina was held. The event included speeches by Jason Kenney, Minister of Citizenship, Immigration and Multiculturalism, and Abraham Abraham, United Nations High Commissioner for Refugees Representative in Canada.

Library and Archives Canada – June 15, 2009As part of World Refugee Week celebrations, the Voices of Refugees Multimedia Installation featured 16 portraits of refugees from Central America, Central Asia, and Africa, two large video projections, and a live performance with Guatema-lan revolutionary singer Tito Medina.

University of Ottawa – June 2, 2009Posters, videos, and performances by revolutionary singer Tito Medina were presented at the Second Annual Conference of the Canadian Association of Refugee and Forced Migration Studies.

National Gallery of Canada – February 25, 2009The Refugee Portrait Workshop provided young artists with a firsthand view of the creation of the Voices of Refuges Multimedia Installation and a session in portraiture development techniques. The workshop also discussed issues of forced migration.

Canadian Centre for International Justice – June 26, 2008Posters from the Voices of Refuges Multimedia Installation were shown at the formal launch of the Canadian Centre for International Justice at Library and Archives Canada. The featured speakers were Maher Arar, Lloyd Axworthy, and Ellen Gabriel.

World Refugee Day – June 20, 2008Posters and videos from the Voices of Refuges Multimedia Installation were presented on World Refugee Day 2008 at Ottawa City Hall, European Economic and Social Committee of Brussels, and the Bell Green Community Centre of Coventry, England. Video was presented on the University of Oxford (England) website. Posters were distributed to relief organizations in Islamabad, San Francisco, Dublin, Tokyo, Melbourne, New York, Washing-ton, London, Brussels, Cairo, and Johannesburg.

What Personal Links or Experiences Do We Have in Relation to the Project?

Tompalski’s Polish/Ukrainian family came to Canada to escape persecution in Eastern Europe. Thompson, who descends from Métis fur traders (Cree/Scottish), has a strong interest in Aboriginal history and the forced migration of the Métis from their traditional territories in Western Canada.

Who Are the Refugee Artists?

Dependent upon funding, we are hoping to feature the following refugees in the World Refugee Week 2010 installation at Library and Archives Canada:

· Victor Fuentes is a songwriter, painter, and activist who was born and educated in El Salvador. Through his music, art, and social activism, Fuentes has helped rebuild commu-nities in his homeland which have struggled to overcome the hardships of a civil war which lasted from 1980 to 1992.

· Hamid Ayoub is a painter who was born and educated in Sudan. He fled the horrors of Darfur on foot across the deserts of Chad, living under the constant threat of starvation and attack by wild animals.

· Tito Medina is a music producer and activist who found his voice as a revolutionary singer/songwriter in the streets of Guatemala City during the turbulent national protests of the early 1970s. His passionate songs cry out for justice in solidarity with the struggles of the Guatemalan people.

· Hawa Kaba is a painter from Guinea, West Africa. She was jailed when she was 15 for requesting a passport, as she was trying to escape the dictatorial regime of Ahmed Sékou Touré, which killed an estimated 50,000 people from 1958 to 1984.

· Martin Mbesha, who was director of the Centre Artistique de Gitega (Burundi), is a sculptor from the Democratic Republic of Congo. Mbesha survived the Second Congo War, which is considered to be the deadliest conflict worldwide since World War II.

For more information on the project, please visit: <http://www.voicesofrefugees.net/>.

The Voices of Refugees Multimedia Installation is planning a five-day event from June 16 to 20 at Library and Archives Canada during World Refugee Week 2010.

18 INSCAN Vol 23 ( 4 ) 2010

* INSCAN Reporter, <cmuonde@connect.carleton.ca>.

A Participant’s Overview

This seminar was organized by the Metropolis Project as part of its “Metropolis Presents” seminar series. The seminar was intended to address a num-ber of key issues regarding ways in which Canada could be more welcoming to immigrants, refugees, and minorities. The following four themes guided the seminar:

• A proactive approach by federal, provincial and municipal governments;

• The role of non-governmental organizations;

• The urban and rural contexts; and

• Francophone and Anglophone minority lan-guage communities.

A Proactive Approach by Federal, Provincial, and Municipal Governments

The first set of presentations explored the theme of proactive approaches by federal, provincial, and municipal governments in integrating newcomers. This theme was intended to examine the role of governments in promoting, building, and maintain-ing welcoming communities; the feasibility of a national project to help integrate newcomers into communities; and how collaboration towards such a cause could occur. Richard A. Wanner, Deborah Tunis, Humphrey Sheehan, Joshua Bates, and Annick Lenoir-Achdjian presented on the theme.

Richard A. Wanner (Department of Sociology, University of Calgary) reported findings from a quantitative study in which he examined the impact of different immigration policies on the economic integration of immigrants in 23 more developed countries, including Canada. His study revealed that immigration policies such as those pertaining to skills selection, family reunification, and refugee inflows have differential impacts on the use of assistance benefits, household income levels, occupational status, and unemployment among immigrants. In particular:

• The rate of asylum seekers (refugees) affects all forms of economic integration negatively.

• Skills selection policies reduce unemploy-ment and increase occupational status among women.

• Annual quota systems reduce the use of welfare benefits and unemployment among immigrants.

• The longer the term of residence rights, the greater the unemployment among men.

• The presence of a family reunification policy increases unemployment among men.

• Permitting other forms of family reunifica-tion or family access to social security has no significant effects on economic integration.

Deborah Tunis (Integration Branch, Citizenship and Immigration Canada (CIC)) highlighted the role of the federal government in creating wel-coming communities for newcomers to Canada. According to CIC, the key components and ideals of a welcoming community include employment opportunities, affordable and appropriate housing, accessible and available public transit, cultural diversity, opportunities for social engagement, and the formation of diverse networks. Tunis empha-sized that, in order for the ideals of a welcoming community to be fully realized, both the receiving community and newcomers have important roles to play. Whereas the welcoming community must be receptive, accessible, and responsive to newcomers, it is of equal importance that newcomers be respon-sible for taking available opportunities and aspire to abide by Canadian laws and customs. Tunis also gave an overview of some of the ways in which the federal government has shared responsibilities with provincial, municipal, and various local stakehold-ers in an attempt to foster welcoming communities.

Humphrey Sheehan (Population Growth Secre-tariat, Government of New Brunswick) presented on the New Brunswick government’s approach to creating welcoming communities. Sheehan re-ported that the province faces population growth challenges due to low fertility rates, declining birth rates, declining and aging population, out-migra-tion (particularly of youth), and relatively small immigration intake. In addition, the province faces challenges of reception, integration, and retention.

ConcilliaMuonde*

“Welcoming Communities” Priority Seminar: How Could Canadian Communities Be More Welcoming?

January 25, 2010, Ottawa

The seminar was intended to address a number of key issues regarding ways in which Canada could be more welcoming to immigrants, refugees, and minorities.

The first set of presentations explored the theme of proactive approaches by federal, provincial, and municipal governments in integrating newcomers.

19INSCAN Vol 23 ( 4 ) 2010

Some of these challenges are a result of, for ex-ample, population homogeneity, and few settlement services. As a response, the provincial government created the Population Growth Secretariat (PGS), whose focus is attraction, immigration, settlement, multiculturalism, repatriation, and retention. The PGS’s approach involves the engagement of stake-holders such as municipal leaders and community champions. It also works towards the creation of the infrastructure that is necessary for newcomer settlement, including provision of language train-ing and public education. Furthermore, the PGS aims to promote community engagement and ca-pacity building through the provision of funding, training, and resources.

Joshua Bates (Federation of Canadian Municipali-ties) talked about the role of Canadian municipali-ties in the integration of newcomers. He pointed out that municipalities are not only at the forefront of responding to the needs of newcomers (such as shelter, employment, public services, and transpor-tation) but also key to the success of provincial and federal initiatives. Bates concluded by asserting that the success of newcomer reception, integration, and retention requires this recognition.

Annick Lenoir-Achdjian (Department of Social Work, Université de Sherbrooke) presented on a provincial-regional-municipal partnership model in the Estrie region of Quebec, including Sher-brooke and seven other regional county municipali-ties. The Estrie CRÉ (Conférence régionale des élus, a regional conference of elected officials) has a four-prong development plan for 2007-2012, the second prong of which concerns human capital and immigration as an engine of growth. The City of Sherbrooke itself has a policy on welcoming and integrating immigrants, in place since 2004, which aims to:

• Provide access to municipal services to all immigrants,

• Foster the representation of immigrants in all areas of municipal activity,

• Foster cross-cultural understanding, and

• Develop the partnership.

The Role of Non-Governmental Organizations

Presentations by Nicole Chaland, Kim Shukla, Ratna Omidvar, and Darren Lund highlighted the role of various non-governmental stakeholders in integrating immigrants.

The role of small and medium-sized enterprises (SMEs) and social enterprises was presented as an

example of how non-governmental organizations help newcomers in their employment integration. In her presentation, Nicole Chaland (Sustainability Solutions Group) gave some examples of social en-terprises from across Canada that are bridging the language barriers that newcomers face in accessing employment. For example, Ethnicity Catering, a catering social enterprise in Calgary, employs people without requiring official language skills or Canadian experience. Kim Shukla (owner of Prairie Global Management, an SME in Steinbach, Manitoba) highlighted the ways in which SMEs contribute to the cause of immigrant economic integration. Drawing on her own experience in employing newcomers in a small enterprise that employs only eight people, she mentioned how challenges such as multiple role demands and lack of information on the needs of newcomers limit the full contribution of SMEs to welcoming communities.

Ratna Omidvar (Maytree Foundation) talked about engaging a variety of actors in immigrant integration. She named these actors as “integration actors,” among whom are employers, educators, unions, community agencies, local government, and media. Indicating that there are 200 million migrant workers in the world today, Omidvar re-ferred to the reality of global cities as a result of urbanization and migration. She then gave some examples of good ideas that were put into use in the global cities of the world, as well as of Maytree initiatives.

Darren Lund (Faculty of Education, University of Calgary) highlighted the importance of social justice to the creation and maintenance of welcom-ing communities. He stressed that the denial and invisibility of equity and social justice issues are some of the many barriers to the integration of newcomers in Alberta. Efforts to promote social justice have received considerable resistance. Hate groups such as the Ku Klux Klan make deliberate efforts to counter any headway made by social jus-tice promotion initiatives. In fact, Lund has himself experienced the backlash in the form of lawsuits and death threats to his anti-discrimination work. He concluded that the promotion of equity and hu-man rights at the community level and through edu-cational institutions is of paramount importance.

The Urban and Rural Contexts

Presentations by Bill Reimer, Miu Chung Yan, Julie Drolet, and Sandeep Kumar Agrawal addressed the issue of integration in urban and rural contexts. Di-verse and unique characteristics of urban and rural environments were stressed. Implications of these environments on integration were also discussed.

Presentations by Nicole Chaland, Kim Shukla, Ratna Omidvar, and Darren Lund highlighted the role of various non-governmental stakeholders in integrating immigrants.

Presentations by Bill Reimer, Miu Chung Yan, Julie Drolet, and Sandeep Kumar Agrawal addressed the issue of integration in urban and rural contexts.

20 INSCAN Vol 23 ( 4 ) 2010

Bill Reimer (Department of Sociology, Concordia University) spoke about welcoming communities in the context of present-day rural communities. Rural communities were not previously as conducive to receiving, integrating, and retaining newcomers as they are at the present time. Unlike old rural communities which were characterized by such factors as low knowledge demand, low mobility, and homogenous demographics, new rural com-munities are characterized by diverse cultures, high knowledge demands, and high mobility. These and other differences make new rural communi-ties more conducive to receiving, integrating, and retaining newcomers. Moreover, factors such as distance and density, structure of the economy, environment, and identity make rural communities uniquely welcoming to newcomers.

Miu Chung Yan (School of Social Work, Univer-sity of British Columbia) presented findings from a research study in which he intended to learn the effectiveness of Neighbourhood Houses (NHs) in bridging newcomers with the community in urban Vancouver. He reported the significant role that Vancouver NHs play in fostering the integration of newcomers by way of building their social capital. For example, NHs offer newcomers information referrals and settlement counselling programs. The strength of these houses comes from such factors as their convenient location within communities and the flexibility with which they meet local needs. However, NHs face challenges that include funding limitations, demographic changes, and limited capacity.

Julie Drolet (School of Social Work and Human Service, Thompson Rivers University) first talked about WelcomeBC, a program set up to assist im-migrants in accessing settlement and integration services, and to build capacity for welcoming and inclusive communities. She then presented find-ings from her study on the settlement experiences of family class immigrants in Kamloops, British Columbia. The study was intended to shed light on the challenges that newcomers face in integrating into small cities. Drolet defined small cities as cities with fewer than 100,000 residents. In Canada, such cities make up 25 percent of the total population. The challenges newcomers face in a small city context are related to access to information, ser-vices, and employment. The study also found that the integration needs of newcomers vary by age. For example, older immigrants are disadvantaged due to the lack of age-specific services. Another finding of the study concerns the importance of Kamloops Immigrant Services, an agency that of-fers a range of services, such as language classes, to newcomers in Kamloops and outlying areas. Drolet

listed several requisites for small cities in order to attract, integrate, and retain newcomers. These include the availability of employment opportuni-ties, development of a community infrastructure, acknowledgement of and sensitivity to cultural issues, and proximity to a metropolitan area with access to services, same-ethnic communities and their goods. Also drawn from the study were a set of recommendations, including the need to raise awareness about cultural diversity, the importance of collaboration among stakeholders, and the provi-sion of services that meet the needs of newcomers, thereby preventing newcomers from leaving.

Sandeep Kumar Agrawal (School of Urban and Re-gional Planning, Ryerson University) presented a case study of Thorncliffe Park, an inner city neigh-bourhood in Toronto whose characteristics qualify it as a welcoming neighbourhood. Agrawal defined a welcoming neighbourhood as one with the ability to include and integrate immigrants, refugees, and minorities; and which offer housing, employment opportunities, schooling, and social services. He also stated that physical, social, economic, cultural, and political dimensions within a community can be a reflection of the extent to which a neighbour-hood is welcoming to newcomers. Between 2001 and 2006, new immigrants made up one-fifth of Thorncliffe Park’s population. Furthermore, the neighbourhood continues to attract new im-migrants, and is known among prospective im-migrants. The physical layout of Thorncliffe Park contributes to its welcoming qualities. For example, the school, the library, and the park are physically located in the middle of the neighbourhood, and there are ethno-specific shopping services, places of worship, banks, social and settlement services. Agrawal concluded that, despite such negative aspects as limited employment opportunities and pockets of isolated populations, all other charac-teristics of Thorncliffe Park seem to suggest that it is indeed a welcoming community.

Francophone and Anglophone Minority Language Communities

The last session featured presentations by Jean-Sébastien Jolin Gignac, Christophe Traisnel, and Michèle Vatz Laaroussi on the theme of Franco-phone and Anglophone minority language com-munities. The presenters gave examples of sustain-able immigrant reception within official language minority communities as good practices that could be adopted by other communities in Canada.

Christophe Traisnel (Department of Political Science, Université de Moncton) spoke about the complexities of identity in the context of Quebec, French language minorities outside of Quebec,

The last session featured presentations by Jean-Sébastien Jolin Gignac, Christophe Traisnel, and Michèle Vatz Laaroussi on the theme of Francophone and Anglophone minority language communities.

21INSCAN Vol 23 ( 4 ) 2010

and what implications these complexities pose for immigrant integration.

Jean-Sébastien Jolin Gignac (Voice of English Speaking Quebec (VEQ)) reported that, accord-ing to a 2008-2009 study conducted by VEQ, Anglophone newcomers face several barriers in integrating into Quebec City, including language barriers, social isolation, employability, and a lack of information on available services. Jolin Gignac talked about the “Quebec City Way,” an approach that has been adopted in Quebec City in order to foster the integration of Anglophone and Allophone newcomers. Jolin Gignac also spoke about the Newcomers Integration Program, a joint project of the English-speaking community and the City of Quebec in partnership with vari-ous communities. The project seeks to foster the integration of English-speaking newcomers and their connections with the Francophone majority. It also aims to develop responsive services to meet the needs of newcomers and of employers who recruit newcomers.

Michèle Vatz Laaroussi (Department of Social Services, Université de Sherbrooke) presented pre-liminary findings from two ongoing studies which aim to determine the ability of Quebec communi-ties to attract and retain newcomers. Preliminary findings from one of the two studies indicate that, in the Estrie region of Quebec, Anglophones face more socio-economic difficulties than do their Francophone counterparts. For example, the in-volvement of Anglophone women in the labour market is lower than that of Francophone women and Anglophones have a lower level of income than that of Francophones.

For more information on the seminar, including program, abstracts, presenters’ biographies, and PowerPoint presentations, please visit the Me-tropolis website at:

<http://canada.metropolis.net/events/metropo-lis_presents/welcoming_seminar.html>.

Racism on the InternetBy Yaman Akdeniz. Strasbourg: Council of Europe Publishing, December 2009, 173 pages

This handbook outlines the complexities of racism through its varied definitions, across countries, and internationally. It highlights how the introduction of the Internet has increased the dissemination of materi-als advocating hatred and racism. At the time of this publication, over 10,000 websites, Internet postings, and social media outlets incited racist or hate propaganda (p. 11).

With the advancement of Web 2.0 technology and access to information sharing, the distribution of hate propaganda has become less restrictive and harder to monitor. The advanced technology allows Internet Service Providers to create websites provoking hatred and racism in regions or countries other than the jurisdictions under which they are personally subject. Forcing social media outlets to respond and react to growing web-based hate has resulted in a pan-national level of accountability.

The purpose of this handbook is to explore responses to Internet hatred and online racism within different scopes. It discusses current local, national, and international responsibilities, as well as partnerships between countries facing more complex cases. It provides legal and policy initiatives for both regulatory and non-regulatory responses, as well as suggestions for the private sector.

For more information, please visit: <http://book.coe.int/EN/ficheouvrage.php?PAGEID=36&lang=EN&produit_aliasid=2461>

22 INSCAN Vol 23 ( 4 ) 2010

Presenters:

JosephGarcea, University of Saskatchewan, Saskatoon, <joe.garcea@usask.ca>

LiviannaTossutti, Brock University, St. Catharines, <ltossutt@brocku.ca>

HélèneCardu,Université Laval, Québec City, <Helene.Cardu@fse.ulaval.ca>

AlejandraBravo,Maytree Foundation, Toronto, <abravo@maytree.com>

MeharoonaGhani,British Columbia Ministry of Citizens’ Services and Ministry Responsible for Multiculturalism and Public Affairs Bureau, Victoria, <Meharoona.Ghani@gov.bc.ca>

SmitaJoshi,Newfoundland and Labrador Department of Human Resources, Labour and Employment, St. John’s, <smitajoshi@gov.nl.ca>

Moderator:

JohnBiles,Metropolis Project, Ottawa, <John.Biles@cic.gc.ca>

T his public panel discussion was organized and hosted by the Metropolis Project. Metropolis is an international network with a primary

focus on research and public policy development related to migration, diversity, and immigrant integration both in Canada and internationally. The event was attended by representatives from more than 30 international, federal, provincial, and municipal governments and non-governmental organizations, and included participation via tele-conference from across the country.

Ümit Kiziltan, Acting Director General, Citizen-ship and Multiculturalism Branch, Citizenship and Immigration Canada (CIC), provided an introduc-tory statement in which he commented that the diversity among the panellists was a great asset. This diverse panel mixed with the wide range of audience members would lead to greater conversa-tion and reflection outside of federal public service discourse.

With the increasingly multicultural population of Canada, the purpose of this event was to discuss policies and initiatives related to anti-racism and anti-discrimination. Kiziltan referred not only to government actors but also to other players such as those who may influence public knowledge and sensitivities as well as shape public discourse.

John Biles, Director of Partnership and Knowledge Transfer with the Metropolis Project, acted as facilitator, as well as making a brief presentation on anti-racism and anti-discrimination. Biles used his presentation to set the stage of the seminar by offering general definitions of both racism and dis-crimination. Two definitions of racism were used, one taken from the Province of British Columbia and the other from the Province of Manitoba. Both definitions illustrate that racism can be considered the act of restricting a person from fully participat-ing in Canadian society based on social, political, economic, and cultural factors. These factors can be both interpersonal and related to the larger social structures such as institutions, policies, and programs. Discrimination, as defined by Section 3 of the Canadian Human Rights Act (2009) is the effect of restriction and unfair treatment because of factors such as race, national or ethnic origin,

colour, and religion. For the purposes of this dis-cussion, Biles highlighted these factors but noted that there are others. He outlined the contours of the problem by providing statistics, demograph-ics, and illustrations, noting that “24 percent of all visible minorities in Canada reported that they felt uncomfortable or out of place because of their ethno-cultural characteristics, all, most, or some of the time.”

Joseph Garcea of the Department of Political Studies at the University of Saskatchewan began his presentation, “Managing Diversity Declara-tions, Statutes/Polices and Strategies/Programs of International, National, Provincial, Territorial Jurisdictions,” by reviewing key conceptual issues and providing a review of the policy documents re-lated to anti-racism at the national, provincial, and territorial levels. He prefaced that this exploration needs to include policy documents from four areas: Anti-Racism, Human Rights, Employment Equity, and Multiculturalism and Interculturalism. Garcea felt that these policy documents are intertwined, related, and overlapped and therefore need to be taken into consideration with anti-racism policy, programs, action plans, and strategies. By mention-ing such policy documents as The International Convention on the Elimination of All forms of Racial Discrimination and Canada’s Action Plan against Racism (2005), he suggested an integration of national and international levels of action plans.

Garcea observed that every level of government has a statute, policy, program, strategy, or action plan that addresses or discusses anti-racism. The term “anti-racism” is not always in the title of such policy responses. However, he has broadly defined anti-racism policy framework to include language related to equality rights, multiculturalism, and human rights. He then explored each of these av-enues of policy documents as they related to race and anti-racism policy at each level of government.

The principal focus and goals of the policy documents can be located in three general policy frameworks:

• Anti-discrimination framework: acts to coun-ter racism, such as anti-hate laws;

KatrinaEldridge

Multiculturalism – Anti-Racism and Anti-Discrimination Activities: What Works and What Doesn’t?

September 29, 2009, Ottawa

23INSCAN Vol 23 ( 4 ) 2010

• Anti-racism framework: acts to reduce or eliminate existing racist attitudes through education or initiatives; and,

• Systemic racism framework: acts to reduce or eliminate structural systemic racism.

Finally, Garcea emphasized the need for anti-racism strategies to be implemented within a multi-level governance system in order to maxi-mize effect. He used policy supplementation as an example of multi-level governance which would result in a more comprehensive, coherent, and ef-fective policy framework.

In her presentation titled “Mapping City-level Re-sponses to Racism and Discrimination,” Livianna Tossutti of the Department of Political Science at Brock University highlighted findings from a study exploring political behaviours and local responses to immigration and diversity challenges. She exam-ined six Canadian cities: Vancouver, Abbotsford, Edmonton, Calgary, Toronto, and Brampton. The question was how these cities both address the issue of anti-racism and anti-discrimination, and respond to it through the implementation of city initiatives. As a guide for her measurement tool, she used the indicators from the Ten Point Action Plan of the International Coalition of Cities against Racism that was supported by UNESCO (2004). The indicators that Tossutti incorporated into her study are: policies and structures; monitoring, vigilance, and data collection; equal employment opportunities and practices; support for diversity in the labour market; and finally, provision of edu-cation in mutual understanding and intercultural dialogue. Through her study, she found that all six cities have existing anti-racism, anti-harassment, or human rights policies. The findings Tossutti shared illustrated how these six cities were faring in comparison with each other as well as to the indica-tors of the Ten Point Action Plan. She concluded that there continues to be a need for anti-racism and anti-discrimination education in these cities specifically to make the cities more welcoming and to educate the general public on the needs of newcomers and immigrants.

Hélène Cardu of the Départment des fondements et pratiques en éducation, Université Laval made a presentation co-authored with Annick Lenoir. Titled “Anti-Racism and Anti-Discrimination, Re-sults of a Survey Conducted among Employers and Unions in the Region of Montreal,” the presentation focused on the challenges that immigrants and vis-ible minorities are currently facing in the province of Quebec. The findings indicate that these popula-

tions face a higher rate of precarious employment and that it is harder for them to find and keep a job compared to the rest of the population, specifically, the French-speaking native Quebecois. Cardu listed some of the challenges as: unemployment, dis-crimination, cultural barriers, religious difference, language skills, and integration into society. In the study, immigrants were found to be more educated than the rest of the population. However, the rate of unemployment among immigrants and visible minorities was much higher than among the rest of the population in Montreal. Survey findings also in-dicate that there are differences between immigrant men and women, and between immigrants of dif-ferent origins. Finding a job and keeping it are the major concern of immigrants and visible minorities. At the same time, they also face additional chal-lenges, including language problems, cultural and religious differences, discrimination, and racism. Cardu concluded her presentation by listing recom-mendations regarding the hiring and employment of immigrants and visible minorities. She stressed that it is the employers and authorities who should advocate for immigrants and visible minorities by pushing for integration, language training, and job training programs. Among the recommendations for employers was the need to increase cultural awareness, acknowledge the importance of diver-sity, and enforce employment equity.

Alejandra Bravo, Manager of Leadership and Learning at the Maytree Foundation, addressed social challenges of diversity in her presentation titled “Diversity Dividend.” These challenges in-clude poverty, underemployment, and other social disadvantages – all of which can be classified as social deficits. The Maytree Foundation responds to racism and works incrementally to seek out practical approaches when dealing with forms of oppression. Bravo made a connection between diversity and prosperity. Declining birth rates and an aging population mean that economic prosperity depends on immigration and attracting immigrants

The event was attended by representatives from more than 30 international, federal, provincial, and municipal governments and non-governmental organizations, and included participation via teleconference from across the country.

Garcea observed that every level of government has a statute, policy, program, strategy, or action plan that addresses or discusses anti-racism.

24 INSCAN Vol 23 ( 4 ) 2010

to Canada. It is time to move beyond participation as employment, and to recognize that participation in civic and political life is also important. Im-migration and policy are something that happen at the national level; whereas settlement and inte-gration happen at the local level. Given this need to encourage greater integration at the local level, Bravo listed some of the practical initiatives that the Maytree Foundation has undertaken to assist with local integration. She then highlighted vari-ous programs. DiverseCity on Board is a program aiming to increase the diversity of leaders on local community boards and in the non-profit sector. School4Civics trains individuals about civic and public office, and to be candidates or strategists in political offices for federal, provincial, or munici-pal governments. The final program, DiverseCity Counts, is a report card that measures diversity leadership. Some highlights of the current report include places in the Greater Toronto Area where a majority of visible minorities and immigrants live, but only a small percentage of them are in leader-ship roles. The next report card will focus on the media. In closing, Bravo stressed that, as they go through the settlement process, newcomers feel a greater need for civic and political participation.

Meharoona Ghani, Director of Multiculturalism and Inclusive Communities within the British Columbia Ministry of Citizens’ Services and Ministry Responsible for Multiculturalism and Public Affairs Bureau, focused on “How Has Racism Changed and What Are the Challenges” in her presentation. She discussed how racism has changed, what the emerging challenges are for policy makers, and what is being done to address these challenges within the province of British Columbia. Racism has become more covert and subtle and, therefore, the action to counteract rac-ism must shift as well. For policy makers, ongo-ing challenges include finding a broader objective definition on a core set of Canadian values which reflect Canada’s diverse and multicultural popula-tion. However, Ghani stressed, this must be done with the conscious consideration to not simply replace the “R” word with more open language. As an illustration, she presented the findings from the Critical Incident Reponses Model, an evalua-tion completed in smaller B.C. communities. The research gathered key evaluative data related to the anti-racism work currently happening in the model and identified program challenges, including com-munity engagement, capacity and resourcing, and, finally, sustainability, evaluation, and monitoring. Ghani also listed promising practices to address

such issues as power imbalances and privileges, community partnerships, capacity building, and engaging youth. In closing, Ghani highlighted how the province has responded to increase anti-racism practices and priority areas, giving examples such as the EmbraceBC.ca website, the development of positive anti-racism messages, and the Provincial Nesika Awards.

The final presentation was by Smita Joshi, Director of Multiculturalism in the Office of Immigration and Multiculturalism for the province of New-foundland and Labrador. The key message in her presentation, “Anti-Racism and Anti-Discrimina-tion Activities: What Works?” was that diversity is a strength and that, in the province, being small is seen as a blessing. Just about 1.5 percent of the population in the province are immigrants who represent 100 countries. Joshi shared findings from two public consultations which found that:

• Diversity and multiculturalism are viewed positively by the general public;

• People recognize the importance of education pertaining to newcomers and immigration; and

• Immigrants are welcomed and integrated into the smaller, rural communities in the province.

Newfoundland and Labrador has taken a proactive approach to create welcoming communities for newcomers. Through the establishment of govern-ment and community partnerships, they have de-veloped a holistic anti-discrimination approach and continue to strive to make the province welcoming for newcomers. Joshi elaborated on the holistic approach to include a representation of policies and procedures to be in line with the programs, services, and strategic partnerships. She stressed that the relationship between education, cultural in-clusiveness, and public awareness is essential when adopting a holistic approach. These partnerships are key to creating, sustaining, and mobilizing a welcoming community for newcomers. Before she closed, she showed a video titled “Multiculturalism Milestones: Celebrating Success!” which was a compilation of the information gathered from the various partnerships.

A question-and-answer session followed the pre-sentations. Questions came from both the floor and online participants.

All presentations are available online at: <http://canada.metropolis.net/events/metropolis_pres-ents/metropolispresents.html>.

The Maytree Foundation responds to racism and works incrementally to seek out practical approaches when dealing with forms of oppression.

Ghani highlighted how the province has responded to increase anti-racism practices and priority areas, giving examples such as the EmbraceBC.ca website, the development of positive anti-racism messages, and the Provincial Nesika Awards.

Newfoundland and Labrador has taken a proactive approach to create welcoming communities for newcomers.

25INSCAN Vol 23 ( 4 ) 2010

“The Red Cross gave us the best of presents when they brought us a message my father had hand-written: He was well and alive and in prison in Iran. It was the first news we had received from him in years.” Son of an Iraqi soldier in detention in Iran during the Iran-Iraq war in the 1980s

Natural disasters and conflicts affect millions of people around the globe every year and often separate family members and loved ones from one another when they need each other most. Some people still do not know what happened to their loved ones after years of separation.

Ayaan left her home in Mogadishu, Somalia, in 1991, when she was 11 years old. Civil war caused her to lose contact with her family. The 28-year old Winnipeg woman has always wondered if her parents and siblings survived the conflict. In November 2006, Ayaan approached the Canadian Red Cross office in Winnipeg for help in finding out. Six months later, Ayaan received a Red Cross message from her mother: She was alive.

In June 2004, a conflict in Congo forced Regine, who was pregnant at the time, to flee with her one-year-old daughter. Her two other daughters, then 10 and 12 years old, were in school at the time. Regine found herself in a refugee camp where she discovered that her husband had been killed, but she was unable to get information about the whereabouts of her eldest daughters. Later that year, Regine and her two younger daughters arrived in Toronto. She asked the Canadian Red Cross for assistance in locating her daughters. Through the Red Cross’s Restoring Family Links Program, her missing daughters were found safe and living with a foster family.

Improving the lives of vulnerable people is at the heart of the mission of the Canadian Red Cross: It means responding not only to the physical needs of people affected by a disaster but also to their emotional needs. The Canadian Red Cross,

Canadian Network for the Health of Survivors of Torture and Organized Violence (ResCanNet)

The BulleTin

Spring 2010 Volume 13.1

Restoring Family Links (RFL) – A Canadian Red Cross Program Helping People Separated from Their Loved Ones by

Conflict, Natural Disaster, or Other Humanitarian CrisisDauniaPavone*

through a network of over 185 Red Cross and Red Crescent Societies around the world, and coordina-tion from the International Committee of the Red Cross (ICRC), helps people restore communication with missing family members and learn the fate of lost loved ones.

What Does the RFL Program Do?

· When communication with a loved one is interrupted due to war, armed conflict, natural disaster, or other humanitarian crisis, the Red Cross will attempt to locate the person and re-establish contact with the family member in Canada.

· When traditional means of communications have been interrupted, for example, when postal service is unavailable and phone com-munication is not possible, the Red Cross of-fers a family messaging service: Hand-written messages are delivered to family members in countries affected by a conflict or natural disaster with the possibility to reply to the sender through a return Red Cross message.

· When contact is suddenly lost between family members for health reasons, the Red Cross will attempt to obtain a health and welfare report on their condition.

· Efforts to obtain certificates of detention will be sought for prisoners of war and civilian detainees from some conflicts who have been visited and registered by the ICRC.

· Through the International Tracing Service, the Red Cross will seek to obtain copies of civilian records from WW II camps for people now living in Canada or their relatives.

· Official documents such as school records and birth certificates can be forwarded to minors, or family members in conflict areas through the Red Cross network.

* Volunteer, Restoring Family Links Program, Canadian Red Cross – BC Coastal Region, Victoria.

26 INSCAN Vol 23 ( 4 ) 2010

ResCanNet is a network of individuals and groups across Canada that support survivors of torture. The goals of ResCanNet are to facilitate interaction between groups and individuals, provide a stronger base of support to service providers, and form a more coherent and powerful voice to advocate on behalf of survivors. Participation or membership in the network is open to groups working directly with survivors of torture; organizations and individuals working with refugees; health groups; cultural groups; and other interested persons.

ResCanNet is currently coordinated by the Cana-dian Centre for Victims of Torture (CCVT).

Contact Person: Mulugeta Abai, Executive DirectorCanadian Centre for Victims of Torture194 Jarvis Street, 2nd FloorToronto, OntarioCanada M5B 2B7

Telephone: 416-363-1066, ext. 225Fax: 416-363-2122E-mail: <mabai@ccvt.org>

Web site: <http://www.ccvt.org/>

One way ResCanNet communicates is through the Bulletin published in INSCAN. We would like to sincerely thank INSCAN for this opportunity. The Bulletin is developed by Ken Agar-Newman of the Victoria Coalition for Survivors of Torture (VCST). Brief submissions to the Bulletin are invited and can be sent to Ken Agar-Newman,

2901 Queenston Street , Victor ia , Br it ish Columbia, Canada V8R 4P4; Fax: 250-370-8885; E-mail: <agarnew@ shaw.ca>. The opinions ex-pressed in the Bulletin are not necessarily those of ResCanNet.

ResCanNet is a member of the International Re-habilitation Council for Torture Victims (IRCT). IRCT is an independent, international health profes-sional organization which promotes and supports the rehabilitation of torture victims and the preven-tion of torture through nearly 200 rehabilitation centres and programs around the world.

IRCT Secretariat: International Rehabilitation Council for Torture Victims P.O. Box 2107 DK-1014 Copenhagen O, Denmark

Telephone: +45 - 33 76 06 00 Fax: +45 - 33 76 05 00 E-mail: <lotte_wissing@irct.org>

Web site: <http://www.irct.org>

The ResCanNet representative on the IRCT Board is John Docherty. John welcomes information from torture survivors as well as individuals and centres that work with survivors of torture. He can be reached by e-mail at: <johndoch@gmail.com>.

The Web site of ResCanNet can be visited at: <http://www.rescannet.2itb.com>. If you wish to subscribe to the list-serv “rescannetlist,” contact ResCanNet at: <rescannetlist@coollist. com>.

· The Canadian Red Cross can process an application for an ICRC Travel Document for a person in Canada without a valid passport or travel document who needs to travel for emigration purposes.

How Does the RFL Program Work?

The service is confidential and free of charge. The persons wish-ing to use this service will approach their local Red Cross office and meet with a volunteer case manager for an interview. Their requests will be sent to the Red Cross / Red Crescent (or to the ICRC) in the relevant country. Then, the Red Cross will search for the family member, deliver a Red Cross message if requested, obtain needed documents, and forward them to the family through the Canadian Red Cross.

Who Can Benefit from the RFL Program?

· People who have lost contact with their family members due to conflict, natural disaster, or another humanitarian crisis, whether recent or long past.

· Persons who want to send a message to their family members in an area affected by conflict or natural disasters or other humanitarian crisis where the traditional means of commu-nication are unavailable.

· People who would like to find out the fate of their relatives and suspect that they were held in camps during WW II or prisoners of war.

· People whose regular communications with family members have suddenly stopped likely for health reasons and who want to have information about the health condition of the family member.

· Persons attempting a family reunification process who need specific documents from their place of origin when this is in a conflict or natural disaster area.

Each year more than 1,000 people seek help from the Canadian Red Cross to re-establish contact with their family members. For more information, contact your local Red Cross office, <http://www.redcross.ca/community.html>, or visit the Canadian Red Cross website at: <http://www.redcross.ca/> (click first on “How We Help” and then on “Restoring Family Links”).